Employee’s Withholding Certificate

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W4 Form
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Name* This field is required.
First Name and Middle Initial
Last Name
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Social Security Number* This field is required.
If your name does not match the name on social security card contact SSA
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Namibia
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Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Palau
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Other
Country
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Marital Status* This field is required.
Single or Married filing separately
Married filing jointly or Qualifying widow(er)
Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual)
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Complete Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5.
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Do only one of the following.

(2a) Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3 - 4); or

(2b) Use the Multiple Jobs Worksheet and enter the result in Step 4(c) below for roughly accurate withholding; or

(2c) If there are only two jobs total, you may check this box. Do the same on Form W-4 of the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld

TIP: To be accurate, submit a 2021 Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator.

Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job.)
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If your total income will be $200,000 or less ($400,000 or less if married filing jointly):
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Multiply the number of qualifying children under age 17 by $2,000
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Multiply the number of other dependents by $500
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Add the amounts above and enter the total here
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(4a) Other income not from jobs:If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may inclide interest, dividends, and retirement income.
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(4b) Deductions:If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.
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(4c) Extra withholding:Enter any additional tax you want withheld each pay period
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Date* This field is required.
Month
Day
Year
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Employee's Signature* This field is required.Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.
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First Date of Employment
Month
Day
Year
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Image Field
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Note: If more than one job has annual wages of more than $120,000 or there are more than three jobs, see Pub. 505 for additional tables; or, you can use the online withholding estimator at www.irs.gov/W4App.
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1. Two jobs If you have two jobs or you’re married filing jointly and you and your spouse each have one job, find the amount from the appropriate table on page 4. Using the “Higher Paying Job” row and the“Lower Paying Job” column, find the value at the intersection of the two household salaries and enter that value on line 1. Then, skip to line 3.
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2. Three jobs:

If you and/or your spouse have three jobs at the same time, complete lines 2a, 2b, and 2c below. Otherwise, skip to line 3.
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2a Find the amount from the appropriate table on page 4 using the annual wages from the highest paying job in the “Higher Paying Job” row and the annual wages for your next highest paying job in the “Lower Paying Job” column. Find the value at the intersection of the two household salaries and enter that value on line 2a.
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2b Add the annual wages of the two highest paying jobs from line 2a together and use the total as the wages in the “Higher Paying Job” row and use the annual wages for your third job in the “Lower Paying Job” column to find the amount from the appropriate table on page 4 and enter this amount on line 2b.
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2c Add the amounts from lines 2a and 2b and enter the result on line 2c.
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3. Enter the number of pay periods per year for the highest paying job.For example, if that job pays weekly, enter 52; if it pays every other week, enter 26; if it pays monthly, enter 12, etc.
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4. Divide the annual amount on line 1 or line 2c by the number of pay periods on line 3.Enter this amount here and in Step 4(c) of Form W-4 for the highest paying job (along with any other additional amount you want withheld)
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1. Enter an estimate of your 2021 itemized deductions Such deductions may include qualifying home mortgage interest, charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 7.5% of your income.
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2. Enter:• $25,100 if you’re married filing jointly or qualifying widow(er) • $18,800 if you’re head of household • $12,550 if you’re single or married filing separately
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3. If line 1 is greater than line 2, subtract line 2 from line 1 and enter the result here. If line 2 is greater than line 1, enter “-0-” .
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4. Enter an estimate of your student loan interest, deductible IRA contributions, and certain other adjustments (from Part II of Schedule 1 (Form 1040)).
See Pub. 505 for more information.
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5. Add lines 3 and 4. Enter the result here and in Step 4(b) of Form W-4.
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